| NPI | 1053546432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 17728) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 6924-123) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-05-28 |